<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Objective</bold>: The purely transnasal endoscopic approach has taken in the last decade a paramount importance in the treatment of pituitary adenomas, but some authors have been linked it to an increase in vascular complications. The aim of this paper is to provide a stepwise description of the vascular risks and steps required to avoid them.<bold>Method</bold>: We present the minimal invasive technique used by the senior author in over 900 transnasal purely endoscopic approaches focusing on the relevant vascular landmarks, preoperative and operative steps taken in order to avoid vascular injury and the management of vascular injury from a multitude of sources.<bold>Conclusion</bold>: Endoscopy has brought a wider field of view, with numerous vascular structures well inside the operating field. This represents control but also higher risk. Solid knowledge of the skull base anatomy and proper preoperative imaging coupled with an experienced surgeon can greatly reduce the vascular risks associated with surgery.</abstract>

Objective: The purely transnasal endoscopic approach has taken in the last decade a paramount importance in the treatment of pituitary adenomas, but some authors have been linked it to an increase in vascular complications. The aim of this paper is to provide a stepwise description of the vascular risks and steps required to avoid them.Method: We present the minimal invasive technique used by the senior author in over 900 transnasal purely endoscopic approaches focusing on the relevant vascular landmarks, preoperative and operative steps taken in order to avoid vascular injury and the management of vascular injury from a multitude of sources.Conclusion: Endoscopy has brought a wider field of view, with numerous vascular structures well inside the operating field. This represents control but also higher risk. Solid knowledge of the skull base anatomy and proper preoperative imaging coupled with an experienced surgeon can greatly reduce the vascular risks associated with surgery.

Tips and Tricks to Manage Vascular Risks Using the Transnasal Endoscopic Approach to Pituitary Adenomas

University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures, Romania

Clinic of Neurosurgery, County Clinical Emergency Hospital Tirgu Mures, Romania

Service de neurochirurgie B, Unité de chirurgie de la base du crâne. Groupement hospitalier Est, Hospices civils de Lyon, Bron, France

Fédération d’endocrinologie du pôle Est, Aile A1, Groupement hospitalier Est, Hospices civils de Lyon, France

Université Claude-Bernard, Lyon-1, Lyon, France

Inserm U1028, CNRS UMR 5292, Centre de neurosciences de Lyon, France

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Objective: The purely transnasal endoscopic approach has taken in the last decade a paramount importance in the treatment of pituitary adenomas, but some...

Tips and Tricks to Manage Vascular Risks Using the Transnasal Endoscopic Approach to Pituitary Adenomas

Published Online: Jan 19, 2016

Page range: 349 - 355

Received: Aug 18, 2015

Accepted: Sep 03, 2015

DOI: https://doi.org/10.1515/amma-2015-0100

Keywords
pituitary adenomas, endoscopy, vascular, skull base

© 2015 Chinezu Rareş et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Tips and Tricks to Manage Vascular Risks Using the Transnasal Endoscopic Approach to Pituitary Adenomas

Published Online: Jan 19, 2016

Page range: 349 - 355

Received: Aug 18, 2015

Accepted: Sep 03, 2015

DOI: https://doi.org/10.1515/amma-2015-0100

Keywordspituitary adenomas, endoscopy, vascular, skull base

© 2015 Chinezu Rareş et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
pituitary adenomas, endoscopy, vascular, skull base